ORCID Profile
0000-0003-3530-1711
Current Organisations
Cricket Australia
,
University of Sydney
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Publisher: BMJ
Date: 20-10-2020
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 15-07-2020
Publisher: SAGE Publications
Date: 02-2020
Abstract: Injury and illness surveillance, and epidemiological studies, are fundamental elements of concerted efforts to protect the health of the athlete. To encourage consistency in the definitions and methodology used, and to enable data across studies to be compared, research groups have published 11 sport- or setting-specific consensus statements on sports injury (and, eventually, illnesses) epidemiology to date. To further strengthen consistency in data collection, injury definitions, and research reporting through an updated set of recommendations for sports injury and illness studies, including a new Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist extension. Consensus statement of the International Olympic Committee (IOC). The IOC invited a working group of international experts to review relevant literature and provide recommendations. The procedure included an open online survey, several stages of text drafting and consultation by working groups, and a 3-day consensus meeting in October 2019. This statement includes recommendations for data collection and research reporting covering key components: defining and classifying health problems, severity of health problems, capturing and reporting athlete exposure, expressing risk, burden of health problems, study population characteristics, and data collection methods. Based on these, we also developed a new reporting guideline as a STROBE extension—the STROBE Sports Injury and Illness Surveillance (STROBE-SIIS). The IOC encourages ongoing in- and out-of-competition surveillance programs and studies to describe injury and illness trends and patterns, understand their causes, and develop measures to protect the health of the athlete. The implementation of the methods outlined in this statement will advance consistency in data collection and research reporting.
Publisher: SAGE Publications
Date: 09-03-2017
Abstract: It is known that some people can, and do, sustain injury over a playing season. However, there is currently little high-quality epidemiological evidence about the risk of, and relationships between, multiple and subsequent injuries. To describe the subsequent injuries sustained by Australian Football League (AFL) players over 1 season, including their most common injury diagnoses. Cohort study Level of evidence, 3. Within-player linked injury data on all date-ordered match-loss injuries sustained by AFL players during 1 full season were obtained. The total number of injuries per player was determined, and in those with injury, the Subsequent Injury Classification (SIC) model was used to code all subsequent injuries based on their Orchard Sports Injury Classification System (OSICS) codes and the dates of injury. There were 860 newly recorded injuries in 543 players 247 players (45.5%) sustained ≥1 subsequent injuries after an earlier injury, with 317 subsequent injuries (36.9% of all injuries) recorded overall. A subsequent injury generally occurred to a different body region and was therefore superficially unrelated to an index injury. However, 32.2% of all subsequent injuries were related to a previous injury in the same season. Hamstring injuries were the most common subsequent injury. The mean time between injuries decreased with an increasing number of subsequent injuries. When relationships between injuries are taken into account, there is a high level of subsequent (and multiple) injuries leading to missed games in an elite athlete group.
Publisher: Elsevier BV
Date: 06-2009
Publisher: MDPI AG
Date: 05-12-2018
Abstract: This study aimed to observe core temperature responses in elite cricket players under match conditions during the summer in Australia. Thirty-eight Australian male cricketers ingested capsule temperature sensors during six four-day first-class matches between February 2016 and March 2017. Core temperature (Tc) was recorded during breaks in play. Batters showed an increase in Tc related to time spent batting of approximately 1 °C per two hours of play (p 0.001). Increases in rate of perceived exertion (RPE) in batters correlated with smaller elevations in Tc (0.2 °C per one unit of elevation in RPE) (p 0.001). Significant, but clinically trivial, increases in Tc of batters were found related to the day of play, wet bulb globe temperature (WBGT), air temperature, and humidity. A trivial increase in Tc (p 0.001) was associated with time in the field and RPE when fielding. There was no association between Tc and WBGT, air temperature, humidity, or day of play in fielders. This study demonstrates that batters have greater rises in Tc than other cricket participants, and may have an increased risk of exertional heat illness, despite exposure to similar environmental conditions.
Publisher: BMJ
Date: 07-04-2008
Publisher: MDPI AG
Date: 16-09-2013
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2002
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2008
Publisher: BMJ
Date: 18-09-2012
Publisher: BMJ
Date: 23-08-2014
Publisher: BMJ
Date: 29-06-2017
Publisher: Academy of Science of South Africa
Date: 05-06-2023
DOI: 10.17159/2078-516X/2023/V35I1A15172
Abstract: Background: Recent guidelines (including a special series in The Lancet) have emphasised a minimal role for imaging when assessing low back pain in adults, as the majority of patients will have non-specific findings on imaging that do not correlate well with pain. Objective: To assess whether the diagnosis of lumbar bone stress injuries in young athletes should be considered an exception to the recommendation to avoid imaging for low back pain in adults. Method: Narrative review. Results: Early lumbar bone stress injury diagnosis has been available via traditional MRI sequences (and its precursor Single Photon Emission Computed Tomography (SPECT)) for 25-30 years. MRI assessments using bone window sequences (such as Volumetric Interpolated Breath-hold Examination (VIBE)) have allowed a better understanding of the diagnosis and prognosis of lumbar bone stress injury in young athletes. MRI with bone sequences has allowed non-radiating scans to serially follow the healing of unilateral stress fractures. In the majority of cases, non-chronic unilateral fractures can heal however, this takes three-six months rather than the six-ten weeks that would be the typical unloading period if using symptoms (only) as a guide. The use of MRI to provide evidence of bony healing (as opposed to fibrous union, which creates the pars defect that predisposes to further bone stress lesions) can lead to better long-term outcomes in athletes. There is evidence to flag this as a structural lesion which is both painful and, more importantly, can heal/resolve if managed correctly. Therefore it represents an important ‘specific’ diagnostic subset within adult low back pain. Conclusion: Structural (rather than functional) management of bone stress injuries in high-demand athletes, such as cricket pace bowlers, is in contrast to the recommendation of functional management for general back pain in adults. Structural management is justified when there are demonstrable superior outcomes of having better structure. Although this has not yet been shown in randomised trials of elite athletes, apparent lengthier Test cricket careers of pace bowlers who do not have pars defects suggest better athletic outcomes if bony healing is achieved. For lower demand young adults, or athletes with established bilateral pars defects, functional management may be more pragmatic.
Publisher: International Society for Horticultural Science (ISHS)
Date: 02-2008
Publisher: BMJ
Date: 21-06-2009
Abstract: Non-steroidal anti-inflammatory drugs (NSAID) are commonly used in sports medicine. NSAID have known anti-inflammatory, analgesic, antipyretic and antithrombotic effects, although their in-vivo effects in treating musculoskeletal injuries in humans remain largely unknown. NSAID analgesic action is not significantly greater than paracetamol for musculoskeletal injury but they have a higher risk profile, with side-effects including asthma exacerbation, gastrointestinal and renal side-effects, hypertension and other cardiovascular diseases. The authors recommend an approach to NSAID use in sports medicine whereby simple analgesia is preferentially used when analgesia is the primary desired outcome. However, based both on the current pathophysiological understanding of most injury presentations and the frequency that inflammation may actually be a component of the injury complex, it is premature to suppose that NSAID are not useful to the physician managing sports injuries. The prescribing of NSAID should be cautious and both situation and pathology specific. Both dose and duration minimisation should be prioritized and combined with simple principles of protection, rest, ice, compression, elevation (PRICE), which should allow NSAID-sparing. NSAID use should always be coupled with appropriate physical rehabilitation. NSAID are probably most useful for treating nerve and soft-tissue impingements, inflammatory arthropathies and tenosynovitis. They are not generally indicated for isolated chronic tendinopathy, or for fractures. The use of NSAID in treating muscle injury is controversial. Conditions in which NSAID use requires more careful assessment include ligament injury, joint injury, osteoarthritis, haematoma and postoperatively.
Publisher: Elsevier BV
Date: 2015
DOI: 10.1016/J.JSAMS.2014.09.002
Abstract: This study examined whether high match fast bowling workloads in the short to medium term were associated with increased bowling injury rates. Prospective cohort study. Over a 15 year period, workload patterns for 235 in idual fast bowlers during time periods from 5 to 26 days were examined to consider whether there was an increased injury rate during the month (28 days) subsequent to the workload. Fast bowlers who bowled more than 50 match overs in a 5 day period had a significant increase in injury over the next month compared to bowlers who bowled 50 overs or less RR 1.54 (95% CI 1.04-2.29). For periods ranging from 12 to 26 days, there was no statistically-significant increase in injury over the next month from exceeding thresholds of certain amounts of overs, although bowlers who bowled more than 100 overs in 17 days had a non-significant increase in injury over the next month RR 1.78 (95% CI 0.90-3.50). There were no statistically-significant increases in subsequent injury risk for high workloads for periods of 12-26 days, although exceeding 100 overs in 17 days (or less) was associated with higher injury rates. Compression of cricket fixtures is likely to have only a minimal contribution to increased fast bowling injury rates being seen in the T20 era (along with sudden workload increases due to transferring between forms of the game, which has been previously established as a major contributor).
Publisher: BMJ
Date: 02-2002
DOI: 10.1136/BJSM.36.1.39
Abstract: Objective: To describe the epidemiology of injuries in the Australian Football League (AFL) over four seasons. Methods: An injury was defined as “any physical or medical condition that caused a player to miss a match in the regular season.” The rationale for this definition was to eliminate a previously noted tendency of team recorders to interpret injury definitions subjectively. Administrative records of injury payments to players who did not play matches determined the occurrence of an injury. Results: The seasonal incidence of new injuries was 39 per club (of 40 players) per season (of 22 matches). The match injury incidence for AFL games was 25.7 injuries per 1000 player hours. The injury prevalence (percentage of players missing through injury in an average week) was 16%. The recurrence rate of injuries was 17%. The most common and prevalent injury was hamstring strain (six injuries per club per season, resulting in 21 missed matches per club per season), followed in prevalence by anterior cruciate ligament and groin injuries. Conclusions: The injury definition of this study does not produce incidence rates that are complete for all minor injuries. However, the determination of an injury is made by a single entity in exactly the same manner for all teams, which overcomes a significant methodological flaw present in other multiteam injury surveillance systems.
Publisher: Informa UK Limited
Date: 05-2010
DOI: 10.2147/OAJSM.S9671
Publisher: Oxford University Press (OUP)
Date: 03-01-2023
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2007
Publisher: BMJ
Date: 16-02-2013
Publisher: BMJ
Date: 08-06-2016
DOI: 10.1136/BJSPORTS-2016-096125
Abstract: Cricket was the first sport to publish recommended methods for injury surveillance in 2005. Since then, there have been changes to the nature of both cricket and injury surveillance. Researchers representing the major cricket playing nations met to propose changes to the previous recommendations, with an agreed voting block of 14. It was decided that 10 of 14 votes (70%) were required to add a new definition element and 11 of 14 (80%) were required to amend a previous definition. In addition to the previously agreed 'Match time-loss' injury, definitions of 'General time-loss', 'Medical presentation', 'Player-reported' and 'Imaging-abnormality' injuries are now provided. Further, new injury incidence units of match injuries per 1000 player days, and annual injuries per 100 players per year are recommended. There was a shift towards recommending a greater number of possible definitions, due to differing contexts and foci of cricket research (eg, professional vs amateur injury surveillance systems vs specific injury category studies). It is recommended that researchers use and report as many of the definitions as possible to assist both comparisons between studies within cricket and with those from other sports.
Publisher: BMJ
Date: 25-07-2014
Publisher: BMJ
Date: 18-10-2012
Publisher: Wiley
Date: 24-08-2012
DOI: 10.1111/J.1445-2197.2012.06181.X
Abstract: The incidence of facial injuries within the Australian Football League (AFL) raises concern and can cause the temporary or permanent loss of function thereby threatening a player's earning potential and length of playing career. The purpose of this study was to identify all facial fractures occurring within the AFL over a 17-season period from 1992 to 2008. We aimed to detail injury trends and possible factors that correlate to a player's risk of sustaining a facial fracture. A case review of the AFL's prospective injury records looking at facial fractures sustained by AFL players over a 17-year period was conducted. We analysed various parameters including frequency, distribution, player location, time of season, player recovery, fracture incidence per season and geographical location of facial fracture. In the recorded period, 175 total facial fractures were sustained by AFL players. A majority of fractures, 108 (62%), were sustained during season matches. Zygomaticomaxillary complex fractures (41%) and mandibular (37%) fractures were the most commonly recorded. Players missed 517 matches because of injury with an average of three matches per injury. The AFL is a high-impact, physically demanding competition resulting in significant numbers of facial fractures. There has been a trend of decreased incidence of facial fractures in the AFL from 2006 to 2008. This trend may be attributable to an AFL rule change, which occurred during the study period. Further injury recording could give a more accurate representation of the impact that future AFL rule changes have.
Publisher: BMJ
Date: 25-03-2016
Publisher: Elsevier BV
Date: 09-2003
DOI: 10.1016/S1440-2440(03)80031-2
Abstract: This study examined the relationship between the bowling workload of first-class cricket fast bowlers and injury with the aim of identifying a workload threshold at which point the risk of injury increases. Ninety male fast bowlers (mean age 27 years, range 18-38 years) from six Australian state squads were observed for the 2000-2001 and/or 2001-2002 cricket seasons. Workload was quantified by examining fixture scorecards and conducting surveillance at training sessions. Injury data was obtained from the Cricket Australia's Injury Surveillance System. Compared to bowlers with an average of 3-3.99 days between bowling sessions, bowlers with an average of less than 2 days (risk ratio (RR) = 2.4, 95% confidence interval (CI) 1.6 to 3.5) or 5 or more days between sessions (RR = 1.8, 95% CI 1.1 to 2.9) were at a significantly increased risk of injury. Compared to those bowlers with an average of 123-188 deliveries per week, bowlers with an average of fewer than 123 deliveries per week (RR = 1.4, 95% CI 1.0 to 2.0) or more than 188 deliveries per week (RR= 1.4, 95% CI 0.9 to 1.6) may also be at an increased risk of injury. There appears to be a dual fast bowling workload threshold beyond which the risk of injury increases and maintaining a workload that is too low or infrequent is an equally significant risk factor for injury as maintaining a high bowling workload. Further study is required to determine the reason why players who bowl infrequently suffer more injuries.
Publisher: BMJ
Date: 26-02-2020
Publisher: BMJ
Date: 12-2010
Publisher: Wiley
Date: 07-01-2011
DOI: 10.1111/J.1600-0838.2010.01253.X
Abstract: The aim of this paper was to provide a descriptive epidemiology of anterior cruciate ligament (ACL) reconstructions in Australia. Data on all ACL reconstructions were collected from July 1, 2003 till June 30, 2008. Main outcome measures were the incidence of ACL reconstructions for Australia, per age group, sex and sport, including estimates of direct costs. There were 50 187 ACL reconstructions over the 5-year period studied. The population-based incidence of ACL reconstructions per 100 000 person-years was 52.0 [95% confidence intervals (CI): 51.6 52.5], higher than previously published incidences from other western countries (Scandinavia 32-38). The population incidence rose rapidly through adolescence and early adulthood and then gradually declined. Males had a higher population incidence than females. Skiing had the highest incidence of ACL reconstructions per 100 000 person-years, followed by Australian rules football, rugby, netball and soccer. The total estimated hospital costs associated with ACL reconstruction surgery were over A$75 million (€45 million) per year. Further research is necessary to examine the causes for the higher population incidence of ACL reconstructions in Australia compared with other countries. The establishment of a national register of ACL injuries, similar to those developed in Scandinavia should be considered.
Publisher: BMJ
Date: 21-04-2015
Publisher: BMJ
Date: 10-2021
DOI: 10.1136/BMJSEM-2021-001227
Abstract: The coronavirus pandemic has given everyone in society an education on the harms of spread of respiratory illness. Young healthy athletes are far less likely to suffer severe adverse consequences of viral illnesses than the elderly and frail, but they are not completely immune. Chronic fatigue (overtraining) is an uncommon outcome and myocarditis a rare one, but they both warrant due consideration. It is, therefore, a sensible in idual strategy to ‘stay home when sick’ if only for these risks. Traditionally though, athletes have tended to push through (train and play when ill) because of competing concerns, such as key events/matches and ‘not wanting to let teammates down’. Data from both low COVID-19 and high COVID-19 countries show that the number of cardiovascular deaths in a society correlates with the number of respiratory deaths at the same time, further linking respiratory viruses to cardiovascular deaths. We are now more aware of public health obligations to prevent the spread of respiratory illnesses, in particular to protect the more vulnerable members the community. This hopefully will correspond with a change in the culture of sport to one where it is considered ‘the right thing to do’, to ‘stay home when sick’.
Publisher: AMPCo
Date: 12-1993
Publisher: BMJ
Date: 06-1998
Abstract: To investigate the prevalence of inguinal canal posterior wall deficiency (sports hernia) in professional Australian Rules footballers using an ultrasound technique and correlate the results with the clinical symptom of groin pain. Thirty five professional Australian footballers with and without groin pain were investigated blind with a dynamic high resolution ultrasound technique for presence of posterior wall deficiency. Fourteen players had a history of significant recent groin pain and ten of these were found to have bilateral inguinal canal posterior wall deficiency (p < 0.01). The relative risk for a history of groin pain with bilateral deficiency was 8.0 (95% confidence interval 1.73 to 37.1). Groin pain was also found to be associated with increasing age (p < 0.01) which was an independent risk factor. Surgical, clinical, and ultrasound follow up for players who underwent hernia repair confirmed the validity of ultrasound as a diagnostic tool. Dynamic ultrasound examination is able to detect inguinal canal posterior wall deficiency in young males with no clinical signs of hernia. This condition is very prevalent in professional Australian Rules footballers, including some who are asymptomatic. There was a correlation between bilateral deficiency and groin pain, although the temporal relationship between the clinical and ultrasound findings is not established by the current study. Ultrasound shows promise as a diagnostic tool in athletes with chronic groin pain who are considered possible candidates for hernia repair.
Publisher: Elsevier BV
Date: 02-2012
DOI: 10.1016/J.JSE.2011.10.020
Abstract: The molecular changes occurring in rotator cuff tears are still unknown, but much attention has been paid to better understand the role of matrix metalloproteinases (MMP) in the development of tendinopathy. These are potent enzymes that, once activated, can completely degrade all components of the connective tissue, modify the extracellular matrix (ECM), and mediatethe development of painful tendinopathy and tendon rupture. To control the local activity of activated proteinases, the same cells produce tissue inhibitors of metalloproteinases (TIMP) that bind to the enzymes and prevent degradation. The balance between the activities of MMPs and TIMPs regulates tendon remodeling, whereas an imbalance produces a collagen dis-regulation and disturbances intendons. ADAMs (a disintegrin and metalloproteinase) are cell membrane-linked enzymes with proteolytic and cell signaling functions. ADAMTSs (ADAM with thrombospondin motifs) are secreted into the circulation, and constitute a heterogenous family of proteases with both anabolic and catabolic functions. Biologic modulation of endogenous MMP activity to basal levels may reduce pathologic tissue degradation and favorably influence healing after rotator cuff repair. Further studies are needed to better define the mechanism of action, and whether these new strategies are safe and effective in larger models.
Publisher: Elsevier BV
Date: 10-2022
Publisher: BMJ
Date: 06-2015
DOI: 10.1136/BJSPORTS-2014-094272
Abstract: Groin injuries are common in sports, particularly multidirectional team sports, but incidence rates across sports other than football (soccer) have been poorly documented. A systematic review (initially using PubMed and SportDiscus databases) was performed to record incidence of groin and groin region injuries in sports. Inclusion criteria included presentation of groin injury incidence data for at least 10 team/squad seasons. Data from 31 studies were included. These used varying injury definitions and also considered varying injury categories from general to specific (all groin/hip region injuries, groin injuries, adductor muscle strains, intra-articular hip injuries). When playing the same sport, men had greater injury incidence of groin injury than women (relative risk, RR 2.45, 95% CI 2.06 to 2.92). Sports with high incidences of groin injury included ice hockey and the football codes. There is variation by player position for rate of groin injury in many sports. Hip injuries have become more commonly diagnosed over the past decade in Australian football (p=0.001) and other sports. There is moderate evidence that men have a higher risk of groin injury than women when playing the same sport. There is some evidence that hip injuries are being increasingly diagnosed in the subset of 'groin injuries' in recent years. It is recommended that injury epidemiology consensus statements aim to include a number of relevant sports to improve injury incidence comparisons among different sports.
Publisher: Wiley
Date: 03-11-2013
DOI: 10.1111/J.1600-0838.2011.01409.X
Abstract: The objective of this study was to investigate regional differences in injury incidence in men's professional football in Europe. A nine-season prospective cohort study was carried out between 2001-2002 and 2009-2010 involving 1357 players in 25 teams from nine countries. Teams were categorized into different regions according to the Köppen-Geiger climate classification system. Teams from the northern parts of Europe (n = 20) had higher incidences of injury overall [rate ratio 1.12, 95% confidence interval (CI) 1.06 to 1.20], training injury (rate ratio 1.16, 95% CI 1.05 to 1.27), and severe injury (rate ratio 1.29, 95% CI 1.10 to 1.52), all statistically significant, compared to teams from more southern parts (n = 5). In contrast, the anterior cruciate ligament injury incidence was lower in the northern European teams with a statistically significant difference (rate ratio 0.43, 95% CI 0.25 to 0.77), especially for noncontact anterior cruciate ligament injury (rate ratio 0.19, 95% CI 0.09 to 0.39). In conclusion, this study suggests that there are regional differences in injury incidence of European professional football. However, further studies are needed to identify the underlying causes.
Publisher: SAGE Publications
Date: 05-1996
DOI: 10.1177/036354659602400321
Abstract: We propose a biomechanical model to explain the pathogenesis of iliotibial band friction syndrome in dis tance runners. The model is based on a kinematic study of nine runners with iliotibial band friction syn drome, a cadaveric study of 11 normal knees, and a literature review. Friction (or impingement) occurs near footstrike, predominantly in the foot contact phase, between the posterior edge of the iliotibial band and the underlying lateral femoral epicondyle. The study subjects had an average knee flexion angle of 21.4° ± 4.3° at footstrike, with friction occurring at, or slightly below, the 30° of flexion traditionally described in the literature. In the cadavers we examined, there was substantial variation in the width of the iliotibial bands. This variation may affect in idual predisposition to iliotibial band friction syndrome. Downhill running pre disposes the runner to iliotibial band friction syndrome because the knee flexion angle at footstrike is reduced. Sprinting and faster running on level ground are less likely to cause or aggravate iliotibial band friction syn drome because, at footstrike, the knee is flexed be yond the angles at which friction occurs.
Publisher: SAGE Publications
Date: 1997
DOI: 10.1177/036354659702500116
Abstract: Hamstring muscle strain is the most prevalent injury in Australian Rules Football, accounting for 16% of play ing time missed as a result of injury. Thirty-seven pro fessional footballers from an Australian Football League team had preseason measurements of ham string and quadriceps muscle concentric peak torque at 60, 180, and 300 deg/sec measured on a Cybex 340 dynamometer. Players were studied prospectively throughout the 1995 season. During that time, six play ers sustained clinically diagnosed hamstring muscle injuries that caused them to miss match-playing time. The injured hamstring muscles were all weaker than in the opposite leg in absolute values and hamstring-to- quadriceps muscle ratios. According to our t-test re sults, hamstring muscle injury was significantly asso ciated with a low hamstring-to-quadriceps muscle peak torque ratio at 60 deg/sec on the injured side and a low hamstring muscle side-to-side peak torque ratio at 60 deg/sec. Flexibility (as measured by the sit-and-reach test) did not correlate with injury. Discriminant-function analysis using the two significant ratio variables re sulted in a canonical correlation with injury of 0.4594 and correctly classified legs into injury groups with 77.4% success. These results indicate that preseason isokinetic testing of professional Australian Rules foot ballers can identify players at risk of developing ham string muscle strains.
Publisher: BMJ
Date: 30-01-2020
Publisher: SAGE Publications
Date: 03-04-2009
Abstract: Limited research in cricket bowlers and baseball pitchers has shown a correlation between workload and injury risk. Acute high bowling workload in cricket leads to increased risk of bowling injury in future matches. Cohort study (prognosis) Level of evidence, 2. One hundred twenty-nine pace (fast) bowlers who bowled in 2715 player matches over a period of 10 seasons were followed to compare overs bowled in each match and injury risk subsequent to the match. Bowlers who bowled more than 50 overs in a match had an injury incidence in the next 21 days of 3.37 injuries per 1000 overs bowled, a significantly increased risk compared with those bowlers who bowled less than 50 overs (relative risk [RR], 1.77 95% confidence interval [CI]: 1.05–2.98). Bowlers who bowled more than 30 overs in the second inning of a match had a significantly increased injury risk per over bowled in the next 28 days (RR, 2.42 95% CI: 1.38–4.26). Time periods of less than 21 days or more than 28 days after the match in question did not yield significant differences in injury risk per over bowled between high and low workload bowlers. High acute workload in cricket fast bowlers may lead to a somewhat delayed increased risk of injury up to 3 to 4 weeks after the acute overload, possibly via a mechanism of damaging immature (repair) tissue. Cricket fast bowling and possibly baseball pitching workloads require scrutiny not just for acute injuries but also for injury prevention in the subsequent month.
Publisher: BMJ
Date: 17-08-2016
DOI: 10.1136/BJSPORTS-2016-096572
Abstract: The modern-day athlete participating in elite sports is exposed to high training loads and increasingly saturated competition calendar. Emerging evidence indicates that inappropriate load management is a significant risk factor for acute illness and the overtraining syndrome. The IOC convened an expert group to review the scientific evidence for the relationship of load—including rapid changes in training and competition load, competition calendar congestion, psychological load and travel—and health outcomes in sport. This paper summarises the results linking load to risk of illness and overtraining in athletes, and provides athletes, coaches and support staff with practical guidelines for appropriate load management to reduce the risk of illness and overtraining in sport. These include guidelines for prescription of training and competition load, as well as for monitoring of training, competition and psychological load, athlete well-being and illness. In the process, urgent research priorities were identified.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2010
Publisher: BMJ
Date: 13-03-2011
DOI: 10.1136/EBM1202
Publisher: Elsevier BV
Date: 12-2003
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2005
DOI: 10.1097/01.JSM.0000188206.54984.65
Abstract: To assess return to play strategies following muscle strains with the desired outcomes of decreased competition play lost and minimized risk for recurrent injury. Literature review of previous studies that examine return to play criteria for the commonly seen muscle strain injuries in sport. There have been no studies directly comparing different return to play approaches. Studies have instead concentrated on recurrence risk factors and prognosis assessment, particularly for hamstring injuries. There is some literature support for risk factors for recurrence such as persisting strength deficits, larger injuries seen on diagnostic imaging, players in high-risk positions or sports, inability to complete functional tasks without pain, and strains of specific high-risk muscles (biceps femoris, central tendon of rectus femoris, medial head of gastrocnemius, adductor longus or magnus). There are no consensus guidelines or agreed-upon criteria for safe return to sport following muscle strains that completely eliminate the risk for recurrence and maximize performance. At this time, it may be a sensible strategy to allow earlier return to play in team sports and accept a low to moderate injury recurrence rate. Improved prognostic assessment of muscle strains with injury identification (MRI) and injury assessment (isokinetic testing) may be assist practitioners to lower, but not eliminate, recurrent injuries.
Publisher: SAGE Publications
Date: 05-2001
DOI: 10.1177/03635465010290030801
Abstract: Muscle strains are common injuries in Australian football and other sports involving sprinting. Between 1992 and 1999, 83,503 player-matches in the Australian Football League were analyzed for risk of muscle strain injuries using logistic regression analysis. There were 672 hamstring, 163 quadriceps, and 140 calf muscle strain injuries. All three types of muscle strains were associated with significant risk factors. For all injuries, the strongest risk factor was a recent history of that same injury and the next strongest risk factor was a past history of the same injury. History of one type of muscle strain increased the risk for certain types of other muscle strains. Age was a risk factor for hamstring and calf muscle strains (even when adjusted for injury history) but was not a risk factor for quadriceps muscle strains. Quadriceps muscle injuries were more common in shorter players and were more likely when there had been less rainfall at the match venue in the previous week. Quadriceps muscle injuries were significantly more common in the dominant kicking leg, whereas hamstring and calf muscle injuries showed no difference in frequency between the dominant and nondominant legs.
Publisher: Elsevier BV
Date: 03-2003
Publisher: BMJ
Date: 03-2006
Publisher: BMJ
Date: 24-11-2017
Publisher: BMJ
Date: 22-02-2011
DOI: 10.1136/BMJ.D4517
Publisher: Springer Science and Business Media LLC
Date: 2002
DOI: 10.2165/00007256-200232070-00002
Abstract: Most soccer, rugby union, rugby league, American football, Australian football and Gaelic football competitions over the world are played on natural grass over seasons that commence in the early autumn (fall) and extend through winter. Injury surveillance in these competitions has usually reported high rates of injury to the lower limb and an increased incidence of injuries early in the season. This 'early-season' bias has not usually been reported in summer football competitions, or in sports played indoors, such as basketball. Although easily compared rates have not often been published there has also been a reported trend towards a greater injury incidence in football played in warmer and/or drier conditions. Injury incidence in American football played on artificial turf has often been reported to be higher than in games played on natural grass. This review concludes that the most plausible explanation for all of these reported findings involves variations in playing surface characteristics. Shoe-surface traction for the average player is the specific relevant variable that is most likely to correlate with injury incidence in a given game of football. Shoe-surface traction will usually have a positive correlation with ground hardness, dryness, grass cover and root density, length of cleats on player boots and relative speed of the game. It is possible that measures to reduce shoe-surface traction, such as, ground watering and softening, play during the winter months, use of natural grasses such as perennial ryegrass (Lolium perenne L.) and player use of boots with shorter cleats, would all reduce the risk of football injuries. The most pronounced protective effect is likely to be on injuries to the lower limb of a noncontact nature, including anterior cruciate ligament injuries. Intervention studies should be performed, both using randomised and historical controls.
Publisher: AMPCo
Date: 04-2018
DOI: 10.5694/MJA17.00764
Publisher: AMPCo
Date: 05-2018
DOI: 10.5694/MJA18.00095
Publisher: Elsevier BV
Date: 10-2019
DOI: 10.1016/J.HRTHM.2019.03.025
Abstract: Screening asymptomatic people with a resting electrocardiogram (ECG) has been theorized to detect latent cardiovascular disease. However, resting ECG screening is not recommended for numerous populations, such as asymptomatic middle-aged (sedentary) people, as it is not sufficiently sensitive to detect coronary artery disease. While the issues raised in this article are largely common to all screening programs, this review focuses on 2 distinct programs: (1) screening elite athletes for conditions associated with sudden cardiac death (SCD) and (2) screening people aged ≥65 years for atrial fibrillation (AF). These 2 settings have recently gained attention for their promise and concerns regarding prevention of SCD and stroke, respectively. If screening is to be done, it must be done well. Organizations conducting screening must consider a range of legal, ethical, and logistical responsibilities that arise from the beginning to the end of the process. This includes consideration of who to screen, timing of screening, whether screening is mandatory, consent issues, and auditing systems to ensure quality control. Good infrastructure for interpretation of ECG results according to expert guidelines and follow-up testing for abnormal screening results, including a pathway to treatment, are essential. Finally, there may be significant implications for those diagnosed with cardiac disease, including insurance, employment, the ability to play sport, and mental health issues. There are several legal risks, and the best protective measures are good communication systems, thorough clinical record-keeping, careful handling of eligibility questions for those diagnosed, and reference to expert guidelines as the standard of care.
Publisher: Hindawi Limited
Date: 2013
DOI: 10.1155/2013/304576
Abstract: Background . Rugby league is a physically demanding team sport and the National Rugby League is the highest-level competition of rugby league in Australia. Frequent tackles and collisions between players result in a high incidence of injury to players. Concussion injuries have been the source of much debate, with reporting varying greatly depending on the definition used. Method . Injury records of 239 players from one professional National Rugby League were analysed during a continuous period of 15 years, with particular interest in the incidence and recurrence of concussions and the change in incidence over time. Result . A total of 191 concussions were recorded, affecting 90 players. The incidence of concussion injuries was found to be 28.33 per 1000 player match hours, with an increase over time ( P = 0.0217 ). Multiple concussions were recorded for 51 players. Conclusion . A statistically significant increase in the incidence of concussion injuries was found, without a concurrent increase in the number of head injuries or total injuries. New rules which mandate removal of players from the field may be beneficial for protection of players on the long term, although they risk being counterproductive, if they make players less likely to report their symptoms during matches.
Publisher: BMJ
Date: 11-06-2010
Abstract: To ascertain whether it is possible to assess countries bidding for international sporting events based on public health and sports medicine criteria. In particular, the authors undertook this exercise for countries bidding for the 2018 Fédération Internationale de Football Association (FIFA) Football World Cup (2018 World Cup). A scorecard framework approach to pose and answer nine relevant questions. Questions were answered using Medline-listed references (where possible) and internet research. England scored the highest overall, largely due to its sports medicine training programme and recognition, and funding of treatment for sports injuries. The Netherlands/Belgium scored highly in the questions relating to public health expenditure, Australia was very strong in sports medicine research, and Japan was the best of the bidding countries in terms of having a lower prevalence of overweight and obese people. It is possible to assess countries bidding for international sporting events based on their performance with respect to sports medicine, physical activity and health promotion criteria. Bodies organising major sporting events such as FIFA and the International Olympic Committee may wish to consider making public health measures part of the bidding criteria for hosting these events.
Publisher: Informa UK Limited
Date: 12-10-2022
Publisher: Elsevier BV
Date: 03-2005
DOI: 10.1016/S1440-2440(05)80019-2
Abstract: The varying methods of cricket injury surveillance projects have made direct comparison of published studies in this field impossible. A consensus regarding definitions and methods to calculate injury rates in cricket was sought between researchers in this field. This was arrived at through a variety of face-to-face meetings, email communication and draft reviews between researchers from six of the major cricket-playing nations. It is recommended that a cricket injury is defined as any injury or other medical condition that either: (a) prevents a player from being fully available for selection for a major match or (b) during a major match, causes a player to be unable to bat, bowl or keep wicket when required by either the rules or the team's captain. Recommended definitions for injury incidence (for matches, training sessions and seasons) and injury prevalence are also provided. It is proposed that match injury incidence is calculated using a denominator based on a standard time estimated for player exposure in matches, for the purposes of simplicity. This will allow all injury surveillance systems, including those with limited resources, to make calculations according to a standard definition. The consensus statement presented provides a standard which, if followed, allows meaningful comparison of injury surveillance data from different countries and time periods, which will assist in the possible identification of risk factors for injury in cricket.
Publisher: S. Karger AG
Date: 2013
DOI: 10.1159/000345030
Abstract: Obesity is associated with numerous short- and long-term health consequences. Low levels of physical activity and poor dietary habits are consistent with an increased risk of obesity in an obesogenic environment. Relatively little research has investigated associations between eating and activity behaviors by using a systems biology approach and by considering the dynamics of the energy balance concept. A significant body of research indicates that a small positive energy balance over time is sufficient to cause weight gain in many in iduals. In contrast, small changes in nutrition and physical activity behaviors can prevent weight gain. In the context of weight management, it may be more feasible for most people to make small compared to large short-term changes in diet and activity. This paper presents a case for the use of small and incremental changes in diet and physical activity for improved weight management in the context of a toxic obesogenic environment.
Publisher: Springer Science and Business Media LLC
Date: 13-09-2015
DOI: 10.1007/S40279-015-0383-Y
Abstract: The high prevalence of injury amongst cricket fast bowlers exposes a great need for research into the risk factors associated with injury. Both extrinsic (environment-related) and intrinsic (person-related) risk factors are likely to be implicated within the high prevalence of non-contact injury amongst fast bowlers in cricket. Identifying and defining the relative importance of these risk factors is necessary in order to optimize injury prevention efforts. The objective of this review was to assess and summarize the scientific literature related to the extrinsic and intrinsic factors associated with non-contact injury inherent to adult cricket fast bowlers. A systematic review was performed in compliance with the PRISMA guidelines. This review considered both experimental and epidemiological study designs. Studies that included male cricket fast bowlers aged 18 years or above, from all levels of play, evaluating the association between extrinsic/intrinsic factors and injury in fast bowlers were considered for inclusion. The three-step search strategy aimed at finding both published and unpublished studies from all languages. The searched databases included MEDLINE via PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Cochrane Controlled Trials Register in the Cochrane Library, Physiotherapy Evidence Database (PEDro), ProQuest 5000 International, ProQuest Health and Medical Complete, EBSCO MegaFile Premier, Science Direct, SPORTDiscus with Full Text and SCOPUS (prior to 28 April 2015). Initial keywords used were 'cricket', 'pace', 'fast', 'bowler', and 'injury'. Papers which fitted the inclusion criteria were assessed by two independent reviewers for methodological validity prior to inclusion in the review using standardized critical appraisal instruments from the Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI). A total of 16 studies were determined to be suitable for inclusion in this systematic review. The mean critical appraisal score of the papers included in this study was 6.88 (SD 1.15) out of a maximum of 9. The following factors were found to be associated with injury: bowling shoulder internal rotation strength deficit, compromised dynamic balance and lumbar proprioception (joint position sense), the appearance of lumbar posterior element bone stress, degeneration of the lumbar disc on magnetic resonance imaging (MRI), and previous injury. Conflicting results were found for the association of quadratus lumborum (QL) muscle asymmetry with injury. Technique-related factors associated with injury included shoulder-pelvis flexion-extension angle, shoulder counter-rotation, knee angle, and the proportion of side-flexion during bowling. Bowling workload was the only extrinsic factor associated with injury in adult cricket fast bowlers. A high bowling workload (particularly if it represented a sudden upgrade from a lower workload) increased the subsequent risk to sustaining an injury 1, 3 or 4 weeks later. Identifying the factors associated with injury is a crucial step which should precede the development of, and research into, the effectiveness of injury prevention programs. Once identified, risk factors may be included in pre-participation screening tools and injury prevention programs, and may also be incorporated in future research projects. Overall, the current review highlights the clear lack of research on factors associated with non-contact injury, specifically in adult cricket fast bowlers. Johanna Briggs Institute Database of Systematic Reviews and Implementation Reports 1387 (Olivier et al., JBI Database Syst Rev Implement Rep 13(1):3-13. doi: 10.11124/jbisrir-2015-1387 , 2015).
Publisher: Elsevier BV
Date: 2008
Publisher: BMJ
Date: 29-02-2020
DOI: 10.1136/BJSPORTS-2019-101921
Abstract: Coding in sports medicine generally uses sports-specific coding systems rather than the International Classification of Diseases (ICD), because of superior applicability to the profile of injury and illness presentations in sport. New categories for coding were agreed on in the ‘International Olympic Committee (IOC) consensus statement: Methods for recording and reporting of epidemiological data on injury and illness in sports 2020.’ We explain the process for determining the new categories and update both the Sport Medicine Diagnostic Coding System (SMDCS) and the Orchard Sports Injury and Illness Classification System (OSIICS) with new versions that operationalise the new consensus categories. The author group included members from an expert group attending the IOC consensus conference. The primary authors of the SMDCS (WM) and OSIICS (JO) produced new versions that were then agreed on by the remaining authors using expert consensus methodology. The SMDCS and OSIICS systems have been adjusted and confirmed through a consensus process to align with the IOC consensus statement to facilitate translation between the two systems. Problematic areas for defining body part categories included the groin and ankle regions. For illness codes, in contrast to the ICD, we elected to have a taxonomy of ‘organ system/region’ (eg, cardiovascular and respiratory), followed by an ‘aetiology athology’ (eg, environmental, infectious disease and allergy). Companion data files have been produced that provide translations between the coding systems. The similar structure of coding underpinning the OSIICS and SMDCS systems aligns the new versions of these systems with the IOC consensus statement and also facilitates easier translation between the two systems. These coding systems are freely available to the sport and exercise research community.
Publisher: SAGE Publications
Date: 03-2001
DOI: 10.1177/03635465010290021301
Abstract: The aim of this study was to examine the interaction between intrinsic (player-related) and extrinsic (environment-related) variables as risk factors for anterior cruciate ligament injury in Australian football. Between 1992 and 1999, 100,820 player-match exposures were analyzed for risk of anterior cruciate ligament injury using logistic regression analysis. There were 63 surgically proven noncontact anterior cruciate ligament injuries. The strongest risk factors were a player history of anterior cruciate ligament reconstruction either in the previous 12 months (relative risk [RR], 11.33 95% confidence interval [CI], 4.02 to 31.91) or before the previous 12 months (RR, 4.44 95% CI, 2.46 to 8.01). Weather conditions that were associated with dry field conditions—high water evaporation in the month before the match (RR, 2.55 95% CI, 1.44 to 4.52) and low rainfall in the year before the match (RR, 2.87 95% CI, 1.30 to 6.32)—were also significantly associated with these injuries. The increased risk of injury in the first 12 months after reconstruction was associated with the reconstructed knee, whereas after 12 months there was an even distribution of new injuries to the reconstructed knee and contralateral knee. A history of anterior cruciate ligament reconstruction is a risk factor for further injury. Weather conditions of high evaporation and low rainfall before matches are associated with noncontact anterior cruciate ligament injury.
Publisher: SAGE Publications
Date: 16-11-2018
Abstract: Concussion in sport is a topic of growing interest in Australia and worldwide. To date, relatively few studies have examined the true incidence of concussion in cricket. Concussion in cricket is more common than current literature suggests. Descriptive epidemiology study. Level 4. This is a prospective registry and subsequent analysis of head impacts and concussions in elite-level male and female cricketers in Australia over 2 seasons (2015-2016 and 2016-2017). A total of 172 male and 106 female domestic and international players in 2015-2016 and 179 males and 98 females in 2016-2017 were included. There were 92 head impacts (29 concussions) in men’s matches and 15 head impacts (8 concussions) in women’s matches. Match incidence rates per 1000 player days were 7.2 head impacts (2.3 concussions) in elite male cricket and 3.7 head impacts (2.0 concussions) in elite female cricket. This equates to a head impact every 2000 balls and concussion every 9000 balls in male domestic cricket. Concussion rates per 1000 player-match hours were 0.4 for elite males and 0.5 for elite females 53% of head impacts in females were diagnosed as concussions compared with 32% in males, and 83% of concussions resulted in missing no more than 1 game. The rate of concussion in cricket is higher than previously appreciated however, the majority of patients recovered quickly, and players generally did not miss much playing time as a result. The institution of concussion policies after head impact, including player substitution, appears to have had an effect on increasing reporting of symptoms, resulting in an increase in diagnosis of concussion. Concussion in cricket is not as infrequent as previously assumed. Ongoing review of the rules and regulations is required to ensure that protection of player welfare lies in parallel with other sporting codes.
Publisher: Springer Science and Business Media LLC
Date: 21-09-2023
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2018
Publisher: BMJ
Date: 27-03-2020
Publisher: BMJ
Date: 17-08-2016
DOI: 10.1136/BJSPORTS-2016-096581
Abstract: Athletes participating in elite sports are exposed to high training loads and increasingly saturated competition calendars. Emerging evidence indicates that poor load management is a major risk factor for injury. The International Olympic Committee convened an expert group to review the scientific evidence for the relationship of load (defined broadly to include rapid changes in training and competition load, competition calendar congestion, psychological load and travel) and health outcomes in sport. We summarise the results linking load to risk of injury in athletes, and provide athletes, coaches and support staff with practical guidelines to manage load in sport. This consensus statement includes guidelines for (1) prescription of training and competition load, as well as for (2) monitoring of training, competition and psychological load, athlete well-being and injury. In the process, we identified research priorities.
Publisher: CSIRO Publishing
Date: 2018
DOI: 10.1071/AH17131
Publisher: BMJ
Date: 14-12-2017
Publisher: Informa UK Limited
Date: 09-2010
DOI: 10.2147/OAJSM.S10622
Publisher: Informa UK Limited
Date: 09-2010
DOI: 10.2147/OAJSM.S10623
Publisher: BMJ
Date: 06-2003
Abstract: To determine the incidence and nature of injuries sustained by elite cricketers during a three season period in order to identify possible injury patterns. Thirty six physiotherapists and 13 doctors working with 11 provincial and the South African national teams completed a questionnaire for each cricketer who presented with an injury during each season to determine anatomical site of injury, month of injury during the season, diagnosis, mechanism of injury, whether it was a recurrence of a previous injury, whether the injury had recurred again during the season, and biographical data. A total of 436 cricketers sustained 812 injuries. Bowling (41.3%), fielding and wicketkeeping (28.6%), and batting (17.1%) accounted for most of the injuries. The lower limbs (49.8%), upper limbs (23.3%), and back and trunk (22.8%) were most commonly injured. The injuries occurred primarily during first class matches (27.0%), limited overs matches (26.9%), and practices (26.8%) during the early part of the season. Acute injuries made up 64.8% of the injuries. The younger players (up to 24 years) sustained 57% of the first time injuries, and the players over 24 years of age sustained 58.7% of the injuries that recurred from a previous season. The injuries were mainly soft tissue injuries predominantly to muscle (41.0%), joint (22.2%), tendon (13.2%), and ligament (6.2%). The primary mechanism of injury was the delivery and follow through of the fast bowler (25.6%), overuse (18.3%), and fielding (21.4%). The results indicate a pattern of cause of injury, with the young fast bowler most likely to sustain an acute injury to the soft tissues of the lower limb while participating in matches and practices during the early part of the season.
Publisher: Elsevier BV
Date: 06-2004
Publisher: Elsevier BV
Date: 11-2020
Publisher: BMJ
Date: 22-06-2013
Publisher: BMJ
Date: 09-03-2015
DOI: 10.1136/BJSPORTS-2014-093683
Abstract: To assess workload-related risk factors for injuries to particular tissue types in cricket fast bowlers. 235 fast bowlers who bowled in 14600 player innings over a period of 15 years were followed in a prospective cohort risk factor study to compare overs bowled in each match (including preceding workload patterns) and injury risk in the 3-4 weeks subsequent to the match. Injuries were categorised according to the affected tissue type as either: bone stress, tendon injuries, muscle strain or joint injuries. Workload risk factors were examined using binomial logistic regression multivariate analysis, with a forward stepwise procedure requiring a significance of <0.05. High acute match workload and high previous season workload were risk factors for tendon injuries, but high medium term (3-month workload) was protective. For bone stress injuries, high medium term workload and low career workload were risk factors. For joint injuries, high previous season and career workload were risk factors. There was little relationship between muscle injury and workload although high previous season workload was slightly protective. The level of injury risk for some tissue types varies in response to preceding fast bowling workload, with tendon injuries most affected by workload patterns. Workload planning may need to be in idualised, depending on in idual susceptibility to various injury types. This study supports the theory that tendons are at lowest risk with consistent workloads and susceptible to injury with sudden upgrades in workload. Gradual upgrades are recommended, particularly at the start of a bowler's career to reduce the risk of bone stress injury.
Publisher: Elsevier BV
Date: 06-2020
DOI: 10.1016/J.JSAMS.2019.12.025
Abstract: To report the compliance and results of an electrocardiogram (ECG) cardiac screening program in male and female elite Australian cricketers. cross-sectional study. Elite cricketers were offered screening in accordance with Cricket Australia policy. Players who consented provided a personal and family history, physical examination and resting 12-lead ECG. An audit (1 February 2019) examined all cardiac screening records for male and female players in all Australian Cricket state squads from 16 years upwards. Data extracted from the Cricket Australia database included the number of players who underwent screening signed waivers opting out and had follow-up tests. ECGs were re-reviewed according to the International Criteria. 710 players were included in the cohort (mean age 20.4±4.9 years, 62% male). 692 (97.5%) players underwent recommended cardiac screening or signed a waiver opting out (1.1%). 173 (24.4%) players were screened (or signed a waiver) more than once. Follow-up testing was conducted for 59 (6.9%) cases. No players were excluded from sport due to a cardiac problem and no major cardiac incidents occurred to any player in the audit cohort. Review of 830 ECGs showed benign athlete heart changes, including sinus bradycardia (33.5%), left ventricular hypertrophy (16.3%), and incomplete artial right bundle branch block (8.4%), were common but abnormal screening ECGs were uncommon (2.0%). An audit of a cardiac screening program in elite Australian cricketers found excellent compliance. A small proportion required follow-up testing and no player was excluded from sport due to a cardiac problem. ECG analysis suggested cricket is a sport of moderate cardiac demands, with benign athlete heart changes common.
Publisher: BMJ
Date: 08-11-2012
Publisher: Informa UK Limited
Date: 28-06-2012
DOI: 10.1080/15438627.2012.680633
Abstract: Accurate documentation of injury incidence is critical for study of injury risk factors and prevention. Comparisons of published incidences of anterior cruciate ligament (ACL) injuries and surgical reconstructions are difficult, however, because of the variations in units. Some studies report absolute time-based denominators (such as annual incidence or incidence per 100,000 person years), whereas others report exposure-based denominators (such as incidence per 1,000 player hours or athlete exposures). We converted exposure-based units into annual incidences to compare various studies. National population studies show annual incidence rates of up to 0.05% per person per year in Australia. Professional athletes in basketball, soccer, and the other football codes report an annual incidence of 0.15%-3.7% in studies with at least a moderate s le size. Annual ACL incidence in amateur sporting groups was generally higher than the entire population but lower than among professional athletes. Converting incidence rates to annual units allowed better comparisons to be made between population rates across different studies.
Publisher: BMJ
Date: 03-06-2009
Publisher: BMJ
Date: 04-03-2017
DOI: 10.1136/BJSPORTS-2016-096790
Abstract: A challenge for sports physicians is to estimate the risk of a hamstring re-injury, but the current evidence for MRI variables as a risk factor is unknown. To systematically review the literature on the prognostic value of MRI findings at index injury and/or return to play for acute hamstring re-injuries. Databases of PubMed, Embase, MEDLINE, Scopus, CINAHL, Google Scholar, Web of Science, LILACS, SciELO, ScienceDirect, ProQuest, SPORTDiscus and Cochrane Library were searched until 20 June 2016. Studies evaluating MRI as a prognostic tool for determining the risk of re-injury for athletes with acute hamstring injuries were eligible for inclusion. Two authors independently screened the search results and assessed risk of bias using standardised criteria from a consensus statement. A best-evidence synthesis was used to identify the level of evidence. Post hoc analysis included correction for insufficient s le size. Of the 11 studies included, 7 had a low and 4 had a high risk of bias. No strong evidence for any MRI finding as a risk factor for hamstring re-injury was found. There was moderate evidence that intratendinous injuries were associated with increased re-injury risk. Post hoc analysis showed moderate evidence that injury to the biceps femoris was a moderate to strong risk factor for re-injury. There is currently no strong evidence for any MRI finding in predicting hamstring re-injury risk. Intratendinous injuries and biceps femoris injuries showed moderate evidence for association with a higher re-injury risk. Registration in the PROSPERO International prospective register of systematic reviews was performed prior to study initiation (registration number CRD42015024620).
Publisher: BMJ
Date: 23-07-2004
Abstract: A professional rugby league player sustained a left eyebrow laceration during a match which immediately started to bleed. Within seconds he was taken to the sideline and had the laceration closed with six staples by the team doctor. Bleeding was arrested and he returned to play, taking the ball within 80 s of suffering the initial laceration, and within 40 s of the stapling procedure. This sequence was captured on video and appeared on television. The staples were removed after the match and the wound sutured. Repair of the wound was uneventful. The staple gun allows bleeding lacerations to be closed within seconds and for players to safely and quickly return to play, whilst minimising the risk of blood-borne infection transmission.
Publisher: BMJ
Date: 21-08-2017
DOI: 10.1136/BJSPORTS-2017-097884
Abstract: Pain is a common problem among elite athletes and is frequently associated with sport injury. Both pain and injury interfere with the performance of elite athletes. There are currently no evidence-based or consensus-based guidelines for the management of pain in elite athletes. Typically, pain management consists of the provision of analgesics, rest and physical therapy. More appropriately, a treatment strategy should address all contributors to pain including underlying pathophysiology, biomechanical abnormalities and psychosocial issues, and should employ therapies providing optimal benefit and minimal harm. To advance the development of a more standardised, evidence-informed approach to pain management in elite athletes, an IOC Consensus Group critically evaluated the current state of the science and practice of pain management in sport and prepared recommendations for a more unified approach to this important topic.
Publisher: Oxford University Press (OUP)
Date: 23-03-2022
Abstract: While athletes are generally very fit, intense exercise can increase the risk of atrial fibrillation. Moreover, other arrhythmias such as atrial flutter or supraventricular tachycardia can cause distressing, exercise-related symptoms. Given symptoms are infrequent and may occur during intense exertion, traditional monitoring devices are often impractical to use during exercise. Smartphone electrocardiograms (ECGs) such as the Alivecor Kardia device may be the portable and reliable tool required to help identify arrhythmias in this challenging population. This case series highlights the use of such devices in aiding the diagnosis of arrhythmias in the setting of exercise-related symptoms in athletes. The six cases in this series included one elite non-endurance athlete, two elite cricketers, one amateur middle-distance runner, and two semi-elite ultra-endurance runners, with an age range of 16–48 years. An accurate diagnosis of an arrhythmia was obtained in five cases (atrial fibrillation/flutter and supraventricular tachycardias) using the smartphone ECG, which helped guide definitive treatment. No arrhythmia was identified in the final case despite using the device during multiple symptomatic events. The smartphone ECG was able to accurately detect arrhythmias and provide a diagnosis in cases where traditional monitoring had not. The utility of detecting no arrhythmia during symptoms in one case was also highlighted, providing the athlete with the confidence to continue exercising. This reassurance and confidence across all cases is perhaps the most valuable aspect of this device, where clinicians and athletes can be more certain of reaching a diagnosis and undertaking appropriate management.
Publisher: Elsevier BV
Date: 06-2002
Publisher: Elsevier BV
Date: 07-2022
DOI: 10.1016/J.SOCSCIMED.2022.115040
Abstract: Religion-based LGBTQA + conversion practices frame all people as potential heterosexuals whose gender aligns with their birth sex (in a cisgender binary model of male and female sexes). Deviation from this heterosexual cisgender social identity model is cast as curable 'sexual brokenness'. However, research shows conversion practices are harmful, and particularly associated with increased experiences of abuse, mental health diagnoses, and suicidality. This paper explores their contribution to the particular harms of moral injury and religious trauma, drawing firstly on the foundational moral injury literature to offer a unique conceptual framework of spiritual harm and moral injury, and secondly on a rare qualitative 2016-2021 study of the spiritual harms reported in semi-structured interviews of 42 survivors of LGBTQA + change and suppression practices in Australia. The paper examines the survivors' support needs around the nature and extent of religious trauma and moral injury, to inform services working towards supporting their recovery from such experiences and their resolution of conflicts deeply bound in their sense of self and belonging. It argues that impairment of conversion survivors' relationships with religious communities, and religious self-concepts, point to the need for additional improvements in pastoral practice.
Publisher: Elsevier BV
Date: 12-2004
DOI: 10.1016/S1440-2440(04)80259-7
Abstract: The aetiology of tendinopathy is poorly understood. A new hypothesis proposed argues that tendinopathy may not be purely a tensile injury, rather that altered mechanics such as compression or stress-shielding may be important. Both tendon compression and a decrease in tendon load (stress-shielding) will induce change in a tendon similar to that seen in an insertional tendinopathy. Stress-shielding as a cause of tendinopathy is supported by the clinical success of operative release of adductor longus. This surgery releases the superficial section of the normal adductor longus tendon at a point distal to the insertion. This may have the effect of transferring stress from the superficial section of the tendon to the stress-shielded deeper portion, and the induction of normal loads in both the deeper and superficial portions of the tendon may assist in tendon recovery. This interesting hypothesis and clinical intervention require further investigation
Publisher: Elsevier BV
Date: 04-2007
Publisher: Elsevier BV
Date: 09-2008
DOI: 10.1016/J.JSAMS.2007.05.009
Abstract: Aprotinin is a collagenase inhibitor previously shown to be effective for treating tendinopathies but associated with systemic allergic reactions. This historical cohort study aimed to determine whether or not the injection regime used affected the risk of allergic reaction and outcome. It compared 223 tendinopathy cases (group R) generally treated with a rapid series of aprotinin injections spaced one to two weekly and 158 cases (group D) generally given a single injection or a delay in their repeat injection(s) of over 6 weeks. Side effects and outcome measures were documented by questionnaire with a response rate of 75%. Systemic allergic reactions occurred in 7% of group R cases compared with 2% in group D (NS). Injections given 2-4 weeks after a previous injection were significantly more likely to lead to allergic reactions (6%) than initial injections (0.3%) and injections given >6 weeks after a previous injection (0.9%) (P<0.05). Overall patient rated satisfaction and outcome measures were similar between groups. In summary the current published regime of multiple aprotinin injections over a period of a few weeks has a fairly high rate of systemic allergic reactions. This can be reduced by minimising repeat injections and recommending a delay of at least 6 weeks between injections. Practitioners using aprotinin must have available facilities to treat anaphylaxis.
Publisher: BMJ
Date: 22-10-2009
Abstract: To assess whether a rule change introduced in the Australian Football League (AFL) before the start of the 2005 season, to limit the run-up of ruckmen at the centre bounce, has been successful in reducing the incidence of knee posterior cruciate ligament (PCL) injuries. Cohort study with historical control. The AFL competition from 1992 to 2008 inclusive. The presence of a rule change (four seasons) compared with the previous 13 seasons ( ided into two eras of seven and six seasons). Occurrence of knee PCL injury during a regular season or finals match, both from all causes and specifically from centre bounce ruck collision mechanisms. From 1992 to 1998 there were 11.0 PCL injuries per 10,000 player-hours, with 0.8 ruck injuries per 10,000 centre bounces. From 1999 to 2004, the rates increased to 12.9 per 10,000 player-hours and 5.6 ruck injuries per 10,000 centre bounces (p<0.01). The rates reduced to 5.9 PCL injuries per 10,000 player-hours and 0.9 ruck injuries per 10,000 centre bounces in the period 2005-2008 following the rule change (p<0.01). There was a lower relative risk in 2005-2008 than in 1999-2004 of incurring a centre bounce ruck PCL injury (0.16 (95% CI 0.04 to 0.69)) or of sustaining any PCL injury (0.45 (95% CI 0.28 to 0.75)). A rule change in the AFL to limit the run-up of ruckmen at the centre bounce has successfully reduced the rate of PCL injuries with this mechanism, with the total incidence of PCL injuries also falling.
Publisher: BMJ
Date: 06-2002
Abstract: To investigate the risks and benefits of the use of local anaesthetic in a descriptive case series from three professional football (rugby league and Australian football) teams. Cases of local anaesthetic use (both injection and topical routes) and complications over a six year period were recorded. Complications were assessed using clinical presentation and also by recording all cases of surgery, incidences of players missing games or leaving the field through injury, and causes of player retirement. There were 268 injuries for which local anaesthetic was used to allow early return to play. There were 11 minor and six major complications, although none of these were catastrophic or career ending. About 10% of players taking the field did so with the assistance of local anaesthetic. This rate should be considered in isolation and not seen to reflect standard practice by team doctors. The use of local anaesthetic in professional football may reduce the rates of players missing matches through injury, but there is the risk of worsening the injury, which should be fully explained to players. A procedure should only be used when both the doctor and player consider that the benefits outweigh the risks.
Publisher: Elsevier BV
Date: 09-2004
Publisher: BMJ
Date: 18-01-2023
Publisher: Wiley
Date: 18-04-2018
DOI: 10.1111/SMS.13086
Abstract: Little is known about the prevalence and associated of morbidity of tendon problems. With only severe cases of tendon problems missing games, players that have their training and performance impacted are not captured by traditional injury surveillance. The aim of this study was to report the prevalence of Achilles and patellar tendon problems in elite male Australian football players using the Oslo Sports Trauma Research Centre (OSTRC) overuse questionnaire, compared to a time-loss definition. Male athletes from 12 professional Australian football teams were invited to complete a monthly questionnaire over a 9-month period in the 2016 pre- and competitive season. The OSTRC overuse injury questionnaire was used to measure the prevalence and severity of Achilles and patellar tendon symptoms and was compared to traditional match-loss statistics. A total of 441 participants were included. Of all participants, 21.5% (95% CI: 17.9-25.6) and 25.2% (95% CI 21.3-29.4) reported Achilles or patellar tendon problems during the season, respectively. Based on the traditional match-loss definition, a combined 4.1% of participants missed games due to either Achilles or patellar tendon injury. A greater average monthly prevalence was observed during the pre-season compared to the competitive season. Achilles and patellar tendon problems are prevalent in elite male Australian football players. These injuries are not adequately captured using a traditional match-loss definition. Prevention of these injuries may be best targeted during the off- and pre-season due to higher prevalence of symptoms during the pre-season compared to during the competitive season.
Publisher: Elsevier BV
Date: 12-2006
DOI: 10.1016/J.JSAMS.2006.05.001
Abstract: This study analyses injuries occurring to Australian male cricketers at the state and national levels over 10 years using recently published international definitions of injury. Data was collected retrospectively for 3 years and then prospectively over the final 7 years. Injury incidence has stayed at a fairly constant level over the 10 years. Injury prevalence has gradually increased over the 10-year period but fell in season 2004-2005. Increasing match scheduling over the 10-year period has probably contributed to the increasing injury prevalence. Fast bowlers miss, through injury, about 16% of all potential playing time, whereas the prevalence rate for all other positions is less than 5%. Some match and schedule-related risks for bowling injury have been noted, including a greater risk of injury in the second innings of first class matches (compared to the first innings), a greater risk of injury in the second game of back-to-back matches and an increased risk of injury in the rare situation of enforcing the follow-on in a test match. The introduction of a boundary rope at all grounds has successfully eliminated the mechanism of injury from collision with fences whilst fielding. Cricket is a much safer sport to play at the elite level for batsmen, fieldsmen, wicketkeepers, and spin bowlers than the football codes, which are the other most popular professional sports in Australia.
Publisher: BMJ
Date: 05-04-2019
Publisher: BMJ
Date: 23-07-2004
Abstract: This paper discusses the theory that subtle lumbosacral canal impingement of the L5 nerve root may be a relatively common occurrence in older footballers and may in fact be a common underlying basis for the age related predisposition towards hamstring and calf strains.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2015
DOI: 10.11124/JBISRIR-2015-1387
Abstract: Review question: which extrinsic and intrinsic factors are associated with non-contact injury in adult cricket pace bowlers?Review objective: the objective of this review is to determine the extrinsic and intrinsic factors associated with non-contact injury in adult pace bowlers. Cricket is generally considered to be a sport of low injury risk compared to other sports. In cricket, the pace bowler strives towards the adoption of a bowling technique with a relatively low injury threat that will, at the same time, allow for a fast (>120km/hr) and accurate delivery to the opposing batsman. However, of all the various roles of the cricket player, the pace bowler has the highest risk of injury, especially for low back and lower limb (lower quarter) injury. The reason for this high risk of injury is due to the inherent, high-load biomechanical nature of the pace bowling action. The high prevalence of injury amongst pace bowlers highlights the great need for research into factors associated with injury.Both extrinsic and intrinsic factors work in combination to predispose the bowler to injury. Extrinsic or environment-related factors include bowling workload (the numbers of overs a bowler bowls), player position (first, second or third change) and time of play (morning or afternoon). A high bowling workload has been linked with a higher risk of injury in pace bowlers. Foster et al. found in an observational study that bowling too many overs in a single spell or bowling too many spells may increase the pace bowler's risk of sustaining a low back injury. In another observational study, Dennis et al. found that an exceptionally high bowling workload as well as an uncommonly low bowling workload is associated with injury risk. The major extrinsic factors for bowling injury identified by Orchard et al. are a high number of match overs bowled in the previous week, number of days of play and bowling second (batting first) in a match. Extrinsic factors are known to make the bowler more susceptible to injury, especially in the presence of intrinsic factors.Intrinsic, or person-related, factors include muscle strength, flexibility, balance and biomechanics. Intrinsic, strength-related factors, such as shoulder depression, horizontal flexion strength for the preferred limb and quadriceps power in the non-preferred limb are also significantly related to back injuries in fast bowlers. Both upper limb and lower limb-related intrinsic factors are known to be associated with injury. A prospective study by Dennis et al. aimed to identify the risk factors for injury in adolescent cricket fast bowlers. Their findings concluded that bowlers with a hip internal rotation range of motion of ≤30° on the leg ipsilateral to the bowling arm were at a significantly reduced risk of injury compared with bowlers with >40° of rotation. Moreover, bowlers with ankle dorsiflexion lunge of 12.1-14.0 cm on the leg contralateral to the bowling arm were at a significantly increased risk of injury compared to bowlers with a lunge of >14 cm. Reduced hamstring flexibility was also associated with lumbar disc abnormalities. Bowling-related biomechanical risk factors for injury have been established such as trunk rotation of the shoulders by to a more side-on position during the delivery stride. Portus et al. also reported that shoulder counter-rotation was significantly higher in bowlers who reported lumbar spine stress fractures, while the non-trunk injured group displayed a more flexed knee at front foot contact and ball release. In addition to the above kinematic risk factors, there are high ground reaction forces associated with the power phase - between the front foot placement and ball release components of the pace bowling action. A combination of kinematic bowling related issues as described above and high ground reaction forces may predispose the bowler to injury.Morton et al. conducted a systematic review on pace bowlers between the ages of 13.7 and 22.5 years on risk factors and successful interventions for cricket-related low back pain. Young cricketers between the ages of 13 and 18 years are different to adults in terms of their physiology which impacts on their predisposition to injury and phases of healing. Young cricketers may differ from an adult population in that young pace bowlers who sustain injuries during their bowling career may have given up on the sport by the time they approach adulthood, and the composition of the adult pace bowler population group is therefore affected by natural selection which may cause this group to differ from the original population. Caution is thus advised when generalizing findings from this young population group to adult pace bowlers which emphasizes the need for studies amongst adult pace bowlers. Furthermore, the review by Morton et al. included articles that specifically investigated factors associated with low back pain. However, due to the interconnectedness between the spine and the lower limbs, kinematic variables affecting the spine will also affect the load placed on the lower limbs with subsequent risk of injury. The interdependent mechanical interactions in a linked segment system such as the system of motion of the low back can be caused by movement coordination patterns in other body segments. The systematic review by Morton et al. only included intrinsic factors while the proposed review will also look at extrinsic factors. Therefore, the primary objective of this review is to determine extrinsic and intrinsic factors associated with non-contact injury in adult pace bowlers.
Publisher: Elsevier BV
Date: 12-2002
Publisher: BMJ
Date: 08-2001
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2018
Publisher: MDPI AG
Date: 08-06-2022
DOI: 10.3390/JCDD9060183
Abstract: Athlete ECG interpretation criteria have been developed and refined from research in athlete populations however, current guidelines are based on available data primarily from Caucasian and Black athletes. This study aimed to assess the impact of ethnicity on ECG interpretation in athletes. A systematic review was conducted of the MEDLINE, EMBASE, Scopus, SPORTDiscus, and Web of Science databases, for papers that assessed athlete screening ECGs and compared findings on the basis of ethnicity. Fifty-one papers which compared ECGs from various ethnicities were included. Most studies assessed Black athletes against Caucasian athletes and found a greater prevalence of T-wave inversion (TWI) (2.6–22.8% vs. 0–5.0%) and anterior TWI (3.7–14.3% vs. 0.6–2.0%). Black athlete subgroups in Africa had TWI (20–40%) and anterior TWI (4.3–18.7%) at a higher prevalence than other Black athletes. Athletes who were defined as mixed-race, Asian, and Pacific Islander are potentially more like Black athletes than Caucasian athletes. Black ethnicity is known to have an impact on the accurate interpretation of athlete ECGs however, there is nuance related to origin of both parents. Asian and Pacific Islander origin also may impact athlete ECG interpretation. Further research is required to assist in distinguishing abnormal and normal athlete ECGs in different ethnic populations.
Publisher: Springer Science and Business Media LLC
Date: 12-2014
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2007
Publisher: Springer Science and Business Media LLC
Date: 10-08-2018
Publisher: Elsevier BV
Date: 05-2012
DOI: 10.1016/J.JSAMS.2011.11.250
Abstract: To study risk factors for hamstring injury in the Australian Football League (AFL), in particular the effect of recent changes in match participation (increased use of the interchange bench) on hamstring injury. Analysis of hamstring match injury statistics extracted from an injury database combined with match participation statistics extracted from a player statistics database. 56,320 player matches in the AFL over the period 2003-2010 were analyzed, in which 416 hamstring injuries occurred. In a Generalized Estimating Equation (GEE) analysis accounting for clustering of different teams, significant predictors of hamstring injuries were recent hamstring injury (RR 4.16, 95% CI 3.19-5.43), past history of ACL reconstruction (RR 1.69, 95% CI 1.09-2.60), past history of calf injury (RR 1.58, 95% CI 1.37-1.82), opposition team making 60 or more interchanges during the game (RR 1.38, 95% CI 1.12-1.68) and player having made 7 or more interchanges off the field in the last 3 weeks (protective RR 0.74, 95% CI 0.59-0.93). These findings suggest that regular interchanges protect in idual players against hamstring injuries, but increase the risk of hamstring injury for opposition players. These findings can be explained by a model in which both fatigue and average match running speed are risk factors for hamstring injury. A player who returns to the ground after a rest on the interchange bench may himself have some short-term protection against hamstring injury because of the reduced fatigue, but his rested state may contribute to increased average running speed for his direct opponent, increasing the risk of injury for players on the opposition team.
Publisher: BMJ
Date: 02-12-2009
Abstract: To establish the relationship between the history of hip and groin injuries in elite junior football players prior to elite club recruitment and the incidence of hip and groin injuries during their elite career. Retrospective cohort study. Analysis of existing data. 500 Australian Football League (AFL) players drafted from 1999 to 2006 with complete draft medical assessment data. Previous history of hip/groin injury, anthropometric and demographic information. The number of hip/groin injuries resulting in > or =1 missed AFL game. Data for 500 players were available for analysis. 86 (17%) players reported a hip/groin injury in their junior football years. 159 (32%) players sustained a hip/groin injury in the AFL. Players who reported a previous hip or groin injury at the draft medical assessment demonstrated a rate of hip/groin injury in the AFL >6 times higher (IRR 6.24, 95% CI 4.43 to 8.77) than players without a pre-AFL hip or groin injury history. This study demonstrated that a hip or groin injury sustained during junior football years is a significant predictor of missed game time at the elite level due to hip/groin injury. The elite junior football period should be targeted for research to investigate and identify modifiable risk factors for the development of hip/groin injuries.
Publisher: Elsevier BV
Date: 08-2005
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 1995
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 31-03-2020
Publisher: BMJ
Date: 08-2002
Abstract: Objective: To describe and analyse injuries and illness occurring in Australian cricket at first class level. Methods: Injuries occurring to the state and national teams were surveyed prospectively between the seasons 1998/1999 and 2000/2001, and the three preceding seasons were surveyed retrospectively. The definition of an injury was detailed and generally required the player to miss playing time in a major match. Results: Average injury match incidence in the seasons studied prospectively varied from a low of 19.0 injuries per 10 000 player hours in first class domestic matches to a high of 38.5 injuries per 10 000 player hours in one day internationals. The average seasonal incidence was 19.2 injuries per squad (25 players) per season (20 matches). Injury prevalence (the percentage of players missing through injury at any given time) was 14% for pace bowlers, 4% for spin bowlers, 4% for batsmen, and 2% for wicket keepers. The most common injuries were hamstring strains, side strains, groin injuries, wrist and hand injuries, and lumbar soft tissue injuries. Bowlers who had bowled more than 20 match overs in the week leading up to a match had an increased risk of sustaining a bowling injury (risk ratio 1.91, 95% confidence interval (CI) 1.28 to 2.85). A further risk for bowling injury is bowling second in a match—that is, batting first (risk ratio 1.62, 95% CI 1.04 to 2.50). A risk factor for injury in fielding is colliding with the boundary fence. Conclusions: Further study is required to determine ways to minimise the risk of injury in fast bowlers. Cricket grounds should mark a boundary line on the playing field to prevent players colliding with fences in the field.
Publisher: BMJ
Date: 06-04-2019
DOI: 10.1136/BJSPORTS-2019-100628
Abstract: The use of video to assist professional sporting bodies with the diagnosis of sport-related concussion (SRC) has been well established however, there has been little consistency across sporting codes with regards to which video signs should be used, and the definitions of each of these signs. The aims of this study were to develop a consensus for the video signs considered to be most useful in the identification of a possible SRC and to develop a consensus definition for each of these video signs across the sporting codes. A brief questionnaire was used to assess which video signs were considered to be most useful in the identification of a possible concussion. Consensus was defined as % agreement by respondents. Existing definitions of these video signs from in idual sports were collated, and in idual components of the definitions were assessed and ranked. A modified Delphi approach was then used to create a consensus definition for each of the video signs. Respondents representing seven sporting bodies (Australian Football League, Cricket Australia, Major League Baseball, NFL, NHL, National Rugby League, World Rugby) reached consensus on eight video signs of concussion. Thirteen representatives from the seven professional sports ranked the definition components. Consolidation and refinement of the video signs and their definitions resulted in consensus definitions for six video signs of possible concussion: lying motionless, motor incoordination, impact seizure, tonic posturing, no protective action—floppy and blank/vacant look . These video signs and definitions have reached international consensus, are indicated for use by professional sporting bodies and will form the basis for further collaborative research.
Publisher: Springer Science and Business Media LLC
Date: 09-04-2019
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2021
Publisher: Elsevier BV
Date: 06-2003
Publisher: Georg Thieme Verlag KG
Date: 18-05-2010
Abstract: Injury to the hamstring muscle complex (HMC) is extremely common in the athletic community. Anatomical and functional aspects of the HMC predispose it to injury, including the fact that the muscles cross two joints and undergo eccentric contraction during the gait cycle. Injury most commonly occurs at the muscle tendon junction but may occur anywhere between the origin and insertion. Complete hamstring avulsions require early surgical repair. The principal indication for imaging is in a triage role to rule out or confirm proximal hamstring avulsion. Acute onset and chronic posterior thigh and buttock pain may relate to pathology at the hamstring origin or muscle tendon junction that can be readily defined on magnetic resonance imaging or, less frequently, ultrasound. Some cases of buttock and thigh pain may relate to spinal pathology. In the elite athlete there is an increasing emphasis on optimizing the rehabilitation process after hamstring injury, to minimize the absence from sports and improve the final outcome. Imaging has a role in confirming the site of injury and characterizing its extent, providing some prognostic information and helping plan treatment. There is increasing interest in the use of growth factors to accelerate healing after muscle and tendon injury. Animal studies have demonstrated clear benefits in terms of accelerated healing. There are various methods of delivery of the growth factors, all involving the release of growth factors from platelets. These include plasma rich in platelets and autologous blood. Clinical studies in humans are very limited at this stage but are promising. At present the World Anti-Doping Authority bans the intramuscular administration of these agents. Other percutaneous injection therapies include the use of Actovegin and Traumeel S and antifibrotic agents.
Publisher: Elsevier BV
Date: 10-2018
DOI: 10.1016/J.HRTHM.2018.04.019
Abstract: Sudden death during sport is a rare but devastating event. Previous research has mostly focused on sudden deaths in young competitive athletes. The purpose of this study was to characterize the demographics and etiologies of sudden cardiac death during sport in Australia. All autopsies conducted at our forensic medicine facility between 2006 and 2015 inclusive were reviewed. Sporting-related deaths among those 7-65 years of age were identified. Data collected included subject height, weight, gender, circumstances of death, and pathologic findings at autopsy. A total of 19,740 autopsies were completed in the study period: 12,395 in subjects age 18-65 years (adults) and 385 in subjects age 7-17 years (children). There were 201 sports-related adult deaths at an incidence rate of 0.76-1.49 per 100,000 participant-years. Of the deaths, 74% were witnessed. Of the adult cases, 68% (n = 136) were due to cardiac causes, with coronary artery disease the most frequent cause (n = 90 [45%]). Structural abnormalities were common in adult cardiac deaths 51 (38%) had cardiac weight ≥500 g, and 75 (55%) had left ventricular wall thickness >15 mm. Of the 15 child deaths, 5 (33%) were arrhythmogenic or presumed arrhythmic, and 5 (33%) were inherited cardiomyopathies (2 hypertrophic cardiomyopathy, 3 arrhythmogenic right ventricular cardiomyopathy). Sudden cardiac death during sport is rare. Deaths are mostly due to coronary artery disease in adults and cardiomyopathy or arrhythmia in children. Because the majority of sports deaths are witnessed, they present an opportunity to enhance outcomes by cardiopulmonary resuscitation training and increased availability of automated external defibrillators at sports venues.
Publisher: The Royal Australian College of General Practitioners
Date: 04-2020
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 17-02-2020
Publisher: SAGE Publications
Date: 21-08-2018
Abstract: The nature of Australian rules football (Australian football) predisposes both unique and common injuries compared with those sustained in other football codes. The game involves a combination of tackling, kicking, high-speed running (more than other football codes), and jumping. Two decades of injury surveillance has identified common injuries at the professional level (Australian Football League [AFL]). To provide an overview of injuries in Australian rules football, including injury rates, patterns, and mechanisms across all levels of play. A narrative review of AFL injuries, football injury epidemiology, and biomechanical and physiological attributes of relevant injuries. The overall injury incidence in the 2015 season was 41.7 injuries per club per season, with a prevalence of 156.2 missed games per club per season. Lower limb injuries are most prevalent, with hamstring strains accounting for 19.1 missed games per club per season. Hamstring strains relate to the volume of high-speed running required in addition to at times having to collect the ball while running in a position of hip flexion and knee extension. Anterior cruciate ligament injuries are also prevalent and can result from contact and noncontact incidents. In the upper limb, shoulder sprains and dislocations account for 11.5 missed games per club per season and largely resulted from tackling and contact. Concussion is less common in AFL than other tackling sports but remains an important injury, which has notably become more prevalent in recent years, theorized to be due to a more conservative approach to management. Although there are less injury surveillance data for non-AFL players (women, community-level, children), many of these injuries appear to also be common across all levels of play. An understanding of injury profiles and mechanisms in Australian football is crucial in identifying methods to reduce injury risk and prepare players for the demands of the game.
Publisher: AMPCo
Date: 02-2006
DOI: 10.5694/J.1326-5377.2006.TB00193.X
Abstract: The use of non-steroidal anti-inflammatory drugs (NSAIDs) to treat most muscle, ligament and tendon injuries should be reassessed. They have, at best, a mild effect on relieving symptoms and are potentially deleterious to tissue healing. Soft-tissue injury associated with definite inflammatory conditions such as bursitis or synovitis or involving nerve impingement does warrant short-term treatment with NSAIDs. Paracetamol has similar efficacy to NSAIDs in soft-tissue injury, is cheaper, and has a lower side-effect profile. It is the analgesic of choice for most soft-tissue injury. Cyclo-oxygenase-2 (COX-2) inhibitors should not be used to treat soft-tissue injuries unless impingement is a major feature and non-selective NSAIDs are contraindicated (eg, coexisting gastric disorder), and the patient is not at cardiovascular risk. Corticosteroid injections for tendon injuries may achieve a mild to moderate reduction in pain for up to 6 weeks. However, they do not promote tendon healing, so should generally be used only when healing is not a critical goal. Promising new therapeutic treatments for soft-tissue injuries include topical glyceryl trinitrate, aprotinin injections, and prolotherapy.
Publisher: CMA Joule Inc.
Date: 04-04-2016
DOI: 10.1503/CMAJ.1150091
Publisher: Informa UK Limited
Date: 12-2016
Publisher: SAGE Publications
Date: 12-2005
Publisher: Elsevier BV
Date: 06-2006
DOI: 10.1016/J.JSAMS.2006.03.020
Abstract: Preventing sports injury has rarely been cited as an appropriate action to respond to the obesity epidemic, and in fact a recent letter has suggested that those playing sport are as responsible for their predicament as those who are obese. This opinion piece argues that it is time for better prevention and management of sports injury to be seen as part of the complex solution to preventing obesity, rather than being a self-inflicted problem that governments should continue to ignore.
Publisher: BMJ
Date: 23-11-2005
Abstract: Background: The International classification of diseases 10-Australian modification (ICD-10-AM) and the Orchard sports injury classification system (OSICS-8) are two classifications currently being used in sports injury research. Objectives: To compare these two systems to determine which was the more reliable and easier to apply in the classification of injury diagnoses of patients who presented to sports physicians in private sports medicine practice. Methods: Ten sports physicians/sports physician registrars each coded one of 10 different lists of 30 sports medicine diagnoses according to both ICD-10-AM and OSICS-8 in random order. The coders noted the time taken to apply each classification system, and allocated an ease of fit score for in idual diagnoses into the systems. The 300 diagnoses were each coded twice more by “expert” coders from each system, and these results compared with those of the 10 volunteers. Results: Overall, there was a higher level of agreement between the different coders for OSICS-8 than for ICD-10-AM. On average, it was 23.5 minutes quicker to complete the task with OSICS-8 than with ICD-10-AM. Furthermore, there was also higher concordance between the three coders with OSICS-8. Subjective analysis of the codes assigned indicated reasons for disagreement and showed that, in some instances, even the “expert” coders had difficulties in assigning the most appropriate codes. Conclusions: Based on the results of this study, OSICS-8 appears to be the preferred system for use by inexperienced coders in sports medicine research. The agreement between coders was, however, lower than expected. It is recommended that changes be made to both OSICS-8 and ICD-10-AM to improve their reliability for use in sports medicine research.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2011
Publisher: CSIRO Publishing
Date: 2017
DOI: 10.1071/AH16198
Publisher: BMJ
Date: 29-11-2008
Publisher: BMJ
Date: 15-01-2020
DOI: 10.1136/BMJ.L6923
Publisher: BMJ
Date: 20-08-2014
DOI: 10.1136/BJSPORTS-2013-092524
Abstract: To determine if the comparison of acute and chronic workload is associated with increased injury risk in elite cricket fast bowlers. Data were collected from 28 fast bowlers who completed a total of 43 in idual seasons over a 6-year period. Workloads were estimated by summarising the total number of balls bowled per week (external workload), and by multiplying the session rating of perceived exertion by the session duration (internal workload). One-week data (acute workload), together with 4-week rolling average data (chronic workload), were calculated for external and internal workloads. The size of the acute workload in relation to the chronic workload provided either a negative or positive training-stress balance. A negative training-stress balance was associated with an increased risk of injury in the week after exposure, for internal workload (relative risk (RR)=2.2 (CI 1.91 to 2.53), p=0.009), and external workload (RR=2.1 (CI 1.81 to 2.44), p=0.01). Fast bowlers with an internal workload training-stress balance of greater than 200% had a RR of injury of 4.5 (CI 3.43 to 5.90, p=0.009) compared with those with a training-stress balance between 50% and 99%. Fast bowlers with an external workload training-stress balance of more than 200% had a RR of injury of 3.3 (CI 1.50 to 7.25, p=0.033) in comparison to fast bowlers with an external workload training-stress balance between 50% and 99%. These findings demonstrate that large increases in acute workload are associated with increased injury risk in elite cricket fast bowlers.
Publisher: AMPCo
Date: 11-2017
DOI: 10.5694/MJA17.00445
Publisher: BMJ
Date: 27-09-2018
DOI: 10.1136/BJSPORTS-2018-099727
Abstract: Video review has become an important tool in professional sporting codes to help sideline identification and management of players with a potential concussion. To assess current practices related to video review of concussion in professional sports internationally, and compare protocols and diagnostic criteria used to identify and manage potential concussions. Current concussion management guidelines from professional national and international sporting codes were reviewed. Specific criteria and definitions of video signs associated with concussion were compared between codes. Rules and regulations adopted across the codes for processes around video review were also assessed. Six sports with specific diagnostic criteria and definitions for signs of concussion identified on video review participated in this study (Australian football, American football, world rugby, cricket, rugby league and ice hockey). Video signs common to all sports include lying motionless/loss of responsiveness and motor incoordination . The video signs considered by the majority of sports as most predictive of a diagnosis of concussion include motor incoordination, impact seizure, tonic posturing and lying motionless. Regulatory requirements, sideline availability of video, medical expertise of video reviewers and use of spotters differ across sports and geographical boundaries. By and large, these differences reflect a pragmatic approach from each sport, with limited underlying research and development of the video review process in some instances. The use of video analysis in assisting medical staff with the diagnosis or identification of potential concussion is well established across different sports internationally. The diagnostic criteria used and the expertise of the video review personnel are not clearly established, and research efforts would benefit from a collaborative harmonisation across sporting codes.
Publisher: BMJ
Date: 09-11-2015
Publisher: Elsevier BV
Date: 12-2004
Publisher: BMJ
Date: 03-2008
Publisher: Elsevier BV
Date: 09-2017
Publisher: BMJ
Date: 18-02-2020
DOI: 10.1136/BJSPORTS-2019-101969
Abstract: Injury and illness surveillance, and epidemiological studies, are fundamental elements of concerted efforts to protect the health of the athlete. To encourage consistency in the definitions and methodology used, and to enable data across studies to be compared, research groups have published 11 sport-specific or setting-specific consensus statements on sports injury (and, eventually, illness) epidemiology to date. Our objective was to further strengthen consistency in data collection, injury definitions and research reporting through an updated set of recommendations for sports injury and illness studies, including a new Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist extension. The IOC invited a working group of international experts to review relevant literature and provide recommendations. The procedure included an open online survey, several stages of text drafting and consultation by working groups and a 3-day consensus meeting in October 2019. This statement includes recommendations for data collection and research reporting covering key components: defining and classifying health problems severity of health problems capturing and reporting athlete exposure expressing risk burden of health problems study population characteristics and data collection methods. Based on these, we also developed a new reporting guideline as a STROBE Extension—the STROBE Sports Injury and Illness Surveillance (STROBE-SIIS). The IOC encourages ongoing in- and out-of-competition surveillance programmes and studies to describe injury and illness trends and patterns, understand their causes and develop measures to protect the health of the athlete. Implementation of the methods outlined in this statement will advance consistency in data collection and research reporting.
Publisher: Informa UK Limited
Date: 29-06-2022
Publisher: SAGE Publications
Date: 04-03-2013
Abstract: Injuries are common in all professional football codes (including soccer, rugby league and union, American football, Gaelic football, and Australian football). To report the epidemiology of injuries in the Australian Football League (AFL) from 1992-2012 and to identify changes in injury patterns during that period. Descriptive epidemiology study. The AFL commenced surveying injuries in 1992, with all teams and players included since 1996. An injury was defined as “any physical or medical condition that causes a player to miss a match in the regular season or finals (playoffs).” Administrative records of injury payments (which are compulsory as part of salary cap compliance) to players who do not play matches determined the occurrence of an injury. The seasonal incidence was measured in units of new injuries per club (of 40 players) per season (of 22 matches). There were 4492 players listed over the 21-year period who suffered 13,606 new injuries/illnesses and 1965 recurrent injuries/illnesses, which caused 51,919 matches to be missed. The lowest seasonal incidence was 30.3 new injuries per club per season recorded in 1993, and the highest was 40.3 recorded in 1998. The injury prevalence (missed matches through injury per club per season) varied from a low of 116.3 in 1994 to a high of 157.1 in 2011. The recurrence rate of injuries was highest at 25% in 1992 and lowest at 9% in 2012 and has steadily fallen across the 21 years ( P .01). The most frequent and prevalent injury was hamstring strain (average of 6 injuries per club per season, resulting in 20 missed matches per club per season recurrence rate, 26%), although the rate of hamstring injuries has fallen in the past 2 seasons after a change to the structure of the interchange bench ( P .05). The rate of knee posterior cruciate ligament injuries fell in the years after a rule change to prevent knee-to-knee collisions in ruckmen ( P .01). Annual public reporting (by way of media release and reports available freely online) of injury rates, using units easily understood by laypeople, has been well received. It has also paved the way for rule changes with the primary goal of improving player safety.
Publisher: Elsevier BV
Date: 06-1998
DOI: 10.1016/S1440-2440(98)80016-9
Abstract: Three thousand and thirty one AFL and 1034 injuries in the VSFL U/18 competition were recorded by club doctors over the 1992, 1993 and 1994 seasons. Hamstring strains had the highest incidence (86.4 per 10,000 player hours) and prevalence (30.2 hours missed per 1000 hours) of any injury in the AFL, but were significantly less common in the U/18 competition. Other injuries which were common in both competitions were ankle sprains, thigh haematomas, concussion, groin strains and head lacerations. Injury prevalence was higher overall in the AFL, with lower limb muscle strains (hamstring, calf, quadriceps) being significantly more prevalent than in the U/18 competition. Injuries which were significantly more prevalent in the U/18 competition included stress fractures and concussion. Subsequent to this study, coaches and medical staff in the U/18 competition were made aware of the high risk of stress fractures in young footballers with heavy training loads. The AFL injury survey is ongoing and in the process of being computerised risk factors for specific injuries with high rates are being studied further.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2003
Publisher: BMJ
Date: 22-06-2022
Publisher: AMPCo
Date: 10-2015
DOI: 10.5694/MJA15.00533
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2018
Publisher: BMJ
Date: 05-02-2020
DOI: 10.1136/BJSPORTS-2019-100755
Abstract: To determine the rates of muscle strain injury recurrence over time after return to play in Australian football and to quantify risk factors. We analysed Australian Football League player data from 1992 to 2014 for rates of the four major muscle strain injury types (hamstring, quadriceps, calf and groin) diagnosed by team health professionals. Covariates for analysis were: recent history (≤8 weeks) of each of the four muscle strains non-recent history ( weeks) of each history of hip, knee anterior cruciate ligament, knee cartilage, ankle sprain, concussion or lumbar injury age indigenous race match level and whether a substitute rule was in place. 3647 (1932 hamstring, 418 quadriceps, 458 calf and 839 groin) muscle strain injuries occurred in 272 759 player matches. For all muscle strains combined, the risk of injury recurrence gradually reduced, with recurrence risks of 9% (hamstring), 5% (quadriceps), 2% (calf) and 6% (groin) in the first match back and remaining elevated for 15 weeks after return to play. The strongest risk factor for each muscle injury type was a recent history of the same injury (hamstring: adjusted OR 13.1, 95% CI 11.5 to 14.9 calf OR 13.3, 95% CI 9.6 to 18.4 quadriceps: OR 25.2, 95% CI 18.8 to 33.8 groin OR 20.6, 95% CI 17.0 to 25.0), followed by non-recent history of the same injury (hamstring: adjusted OR 3.5, 95% CI 3.2 to 3.9 calf OR 4.4, 95% CI 3.6 to 5.4 quadriceps OR 5.2, 95% CI 4.2 to 6.4 groin OR 3.5, 95% CI 3.0 to 4.0). Age was an independent risk factor for calf muscle strains (adjusted OR 1.6, 95% CI 1.3 to 2.0). Recent hamstring injury increased the risk of subsequent quadriceps (adjusted OR 1.8, 95% CI 1.2 to 2.7) and calf strains (OR 1.8, 95% CI 1.2 to 2.6). During the ‘substitute rule’ era (2011–2014), hamstring (adjusted OR 0.76, 95% CI 0.67 to 0.86), groin (OR 0.78, 95% CI 0.65 to 0.93) and quadriceps (OR 0.70, 95% CI 0.53 to 0.92) strains were less likely than outside of that era but calf (OR 1.6, 95% CI 1.3 to 1.9) strains were more likely than before the substitute rule era. Recent injury is the greatest risk factor for the four major muscle strains, with increased risk persisting for 15 weeks after return to play.
Publisher: BMJ
Date: 04-2005
Publisher: Elsevier BV
Date: 07-2011
Publisher: BMJ
Date: 12-2016
Publisher: SAGE Publications
Date: 07-2010
Abstract: Local anesthetic pain-killing injections are commonly used by some professional football teams to allow continued play for certain injuries however, the long-term safety of this practice has not been studied. The majority of local anesthetic injections administered in professional football are helpful and safe, not leading to long-term sequelae. Case series Level of evidence, 4. A retrospective survey was conducted of 100 players over 10 seasons who had been injected with local anesthetic on 1023 occasions for 307 injuries (81% follow-up average follow-up, 5 years minimum, 1 year). A comparison of match performance statistics was made from 3 seasons between players using and not using local anesthetic. The majority (98%) of players would repeat the procedure if they had their injury again, although 32% felt that there were side effects associated with the procedure (including 22% who thought that the recovery of the primary injury was delayed and 6% who thought that the injury was worsened by playing with local anesthetic). On long-term follow-up, only 6% of players had significant residual pain in the body part injected. The satisfaction rates for acromioclavicular injuries, finger injuries, rib injuries, and iliac contusions were higher than for sternum injuries, wrist injuries, and ankle injuries. Player performance between those players injected and not injected with local anesthetic was not substantially different and mainly reflected a positional bias for the players who used local anesthetic. The most commonly injected injuries—acromioclavicular joint sprains, finger and rib injuries, and iliac crest contusions—appear to be quite safe (in the context of professional sport) to inject at long-term follow-up. Conversely, ankle, wrist, and sternum injections appear to be less safe. A few injuries may have been substantially worsened by playing after an injection.
Publisher: Elsevier BV
Date: 07-2011
DOI: 10.1016/J.JSAMS.2011.02.002
Abstract: Hip and groin pain are common problems in Australian football. Although indigenous (I) players are at greater risk of soft tissue injury than their non-indigenous (non-I) counterparts, Aboriginal descent has not previously been identified as a risk factor for hip and groin injury. The aim of this study was to investigate if hip and groin screening tests would demonstrate differences between indigenous and non-indigenous junior elite AF players. Cross-sectional study. Two hundred and seventy elite junior Australian football players were screened using five hip and groin musculoskeletal tests. Thirty-three players (12%) were indigenous. Differences were demonstrated between the two groups for right prone hip internal rotation (I X = 27.60 ± 9.16, non-I X = 33.39 ± 8.88, p < 0.001) and left prone hip internal rotation (I X = 25.83 ± 10.25, non-I X = 31.36 ± 8.75, p 0.001). The indigenous players displayed less range of passive hip internal rotation with the hip in neutral, reduced adductor squeeze force and higher levels of groin pain with the squeeze test at 90°. The differences observed between indigenous and non-indigenous players suggest indigenous players are at greater risk of hip and groin injuries in Australian football.
Publisher: BMJ
Date: 13-11-2019
DOI: 10.1136/BJSPORTS-2017-097930
Abstract: Lumbar bone stress injury (‘bone stress injury’) is common in junior fast bowlers. The repetitive loading of cricket fast bowling may cause bone marrow oedema (BMO), detectable on MRI, before the bowler suffers from symptomatic bone stress injury. We investigated the temporal relationship between BMO, bone stress injury, along with bowling workload correlates, in elite junior fast bowlers throughout a cricket season. 65 junior fast bowlers were prospectively monitored for one 8-month cricket season. For research purposes, participants had up to six MRI scans at set times in the season findings were withheld from them and their clinicians. Standard practices for bowling workload monitoring and injury diagnosis were followed. 15 (23%) participants developed bone stress injury during the study. All 15 of these participants had BMO detected on at least one of the preceding MRI scans, including the scan immediately prior to diagnosis. The risk of BMO progressing to bone stress injury during the season was greatest for participants with BMO present 2 weeks prior to the national ch ionship tournament (period of high load) (RR=18.9, OR=44.8). Both bone stress injury and BMO were associated with bowling a higher percentage of days in training and having a shorter bowling break during the season. The number of balls bowled and acute-to-chronic workload were not associated with imaging abnormalities or injury. The presence of BMO on MRI in asymptomatic junior cricket fast bowlers confers a very high risk for bone stress injury. The risk may be managed by MRI screening and monitoring bowling frequency.
Publisher: BMJ
Date: 12-2016
Publisher: Elsevier BV
Date: 2023
Publisher: BMJ
Date: 06-2002
Abstract: A left gastrocnemius strain was sustained by an elite cricket batsman while he was taking off to run. The exact moment of injury, captured by a camera in the middle stump, appears to correspond to the sudden appearance of a deficit in the gastrocnemius muscle, seen through the player's trousers. The strain occurred when the entire body weight was on the left foot with the centre of mass well in front of the leg. The injury probably occurred close to the time when the gastrocnemius complex was moving from an eccentric to an isometric phase.
Publisher: Elsevier BV
Date: 06-2004
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2018
Publisher: BMJ
Date: 06-2014
Publisher: Elsevier BV
Date: 08-2005
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2001
Publisher: Elsevier BV
Date: 06-2008
DOI: 10.1016/J.JSAMS.2007.07.001
Abstract: All forms of management in medicine involve weighing up: (1) the potential benefits or efficacy of treatment (2) the potential side effects of treatment and (3) the costs or cost-effectiveness of treatment. It is well established that the randomised control trial (RCT) is the gold standard for determining treatment efficacy and it is obvious why RCTs should be subjected to ethical screening. However, RCTs are not the best methodology for every study, particularly as they are so expensive to conduct. Observational studies are particularly valuable for studying side effects and cost-effectiveness of treatment and still have value (albeit of a lesser quality) in assessing treatment efficacy. Most observational clinical studies are not ethically sensitive and, if it is agreed that therefore ethics committee screening is therefore not required for these studies, they can be completed at low cost with minimal need for industry sponsorship. Universal ethics committee requirements for all observational clinical papers would act as an unnecessary barrier to obstruct the publication of useful studies. Paradoxically, the need in many cases to seek industry funding to cover the extra expense for such a requirement would probably make observational studies less ethically sound.
Publisher: Elsevier BV
Date: 06-2001
DOI: 10.1016/S1440-2440(01)80032-3
Abstract: Five hundred and seventy one matches in the Australian Football League [AFL] had ground hardness measured using a Penetrometer, over the period 1997-2000. The method used was 3 drops at each of 20 locations over the playing field on the morning before games. Anterior Cruciate Ligament [ACL] injuries were recorded using an ongoing injury surveillance system. There was a non-significant trend towards a higher risk of ACL injury when the 3-drop average of the Penetrometer was less (harder) than 4.5cm, RR 2.36 (95% CI 0.90-6.24). When the first drop average of the Penetrometer was less (harder) than 2.5cm, the relative risk was 2.60 (95% CI 0.94-7.20). There was also a nonsignificant trend towards an increased risk of ACL injury in games where the predominant grass type was couch (Bermuda) grass, as opposed to rye grass, RR 2.37 (95% CI 0.89-6.36). This study confirms previous findings from the AFL that early season matches and matches played at northern (warmer) venues have a higher risk of ACL injury. It is likely that ground-related variables are partially responsible for these observations, but to date, the relative contributions of ground hardness, grass type, shoe-surface traction and other confounding factors are not certain. There was a significant fall in the number of ACL injuries in the AFL (to approximately half the previous level of incidence) during seasons 1999 and 2000. It is possible that reaction to this study and related publicity has led to the preparation of ground conditions in the AFL that are less likely to produce ACL injuries.
Publisher: Elsevier BV
Date: 12-2003
Publisher: BMJ
Date: 10-2005
Publisher: Springer Science and Business Media LLC
Date: 2004
DOI: 10.2165/00007256-200434040-00001
Abstract: The use of local anaesthetic painkilling injections in professional football can counter the performance-reducing impact of injury and lower the rate of players missing matches through injury. In the majority of cases, these injections are probably safe, although scientific evidence in this area is scant, particularly regarding long-term follow-up. The known long-term injury sequelae of professional football, such as increased rates of osteoarthritis of the knee (in particular), hip, ankle and lumbar spine, do not generally relate to the injuries for which local anaesthetic is commonly used. The most commonly injected injuries (acromioclavicular joint sprains, finger and rib injuries and iliac crest haematomas) are probably the safest to inject. There are risks of worsening injuries and known specific complications when local anaesthetic is used, and players requesting injections should be made aware of these. Local anaesthetic injections as painkillers should only be used when both the doctor and player consider that the benefits clearly outweigh the anticipated possible risks. Intra-articular injections to the knee, ankle, wrist, joints of the foot, and to the pubic symphysis and major tendons of the lower limb are best avoided in most circumstances. To enable the benefit and risk profile of local anaesthetic injections to be better understood, it is recommended that professional football competitions make local anaesthetics legal only with compulsory notification.
Location: Australia
No related grants have been discovered for John Orchard.